Just starting out on advocacy on air pollution? First, learn how you can get started and then find inspiration.
Prepare answers to difficult questions
As advocacy often involves challenging the status quo, it’s worth being prepared for difficult questions. These may come from patients and their families, colleagues, your own family and friends, or the media. The RCPCH Clean Air Fund Partnership team has compiled a list of questions that we and our Clean Air Network members come across frequently, along with examples of how to answer them. If you think we’ve missed any, or if you have a question for us to answer, please get in touch at cleanair@rcpch.ac.uk.
Have a look at our case studies library to read some reflections on answering difficult questions from Dr Lucy Reynolds, one of our Clean Air Network members who is also an experienced child health advocate and paediatrician working in Scotland.
- My colleagues are worried about burdening families with an unsolvable problem. How should I respond to this?
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It’s understandable to be worried about bringing up problems that we cannot help our patients with – this often taps into our own feelings of vulnerability, because the capacity to help people is central to our professional identity, so it’s difficult for us when we don’t feel able to do this. However, withholding information that could enable our patients to avoid health harm is not the solution.
To help yourself and your patients feel less helpless, focus on exploring what they already know and feel about air pollution, and aim to identify those solutions that your patients do have the power to change for themselves (such as choosing walking routes away from busy roads), whilst acknowledging that they are not individually to blame for the problems they face due to air pollution. Then reassure them that doctors and others are working hard on their behalf to push for change on a larger scale.
For more on this, have a read of our section on the ethical dilemma.
- Air quality was so much worse when I was a child. Why should I still worry about it?
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It’s true that there has been significant progress in improving air quality since the Clean Air Acts of the 1950s and 60s.1 Lots of this progress has come from policy measures aimed at reducing air pollution at source, such as Euro standards, which restrict especially polluting road vehicles. As improvements are made, we continue to develop a more detailed understanding of the health impacts of air pollution. New evidence has compelled the WHO to tighten its air quality guidelines, however scientists agree that there are ultimately no safe limits, and we should reduce air pollution as much as we possibly can.
Cases like that of Ella Adoo Kissi-Debrah, who died in 2013 aged 9, and Awaab Ishak, who died in December 2020 aged 2, highlight the ongoing severe child health impacts of air pollution and the need for action to improve both indoor and outdoor air quality.
For more on the child health impacts of air pollution, see our build your knowledge page.
- My colleague wants to get started with advocacy work on air pollution but they are worried about being too political. How should I respond to this?
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Advocacy work is outside the comfort zone of many healthcare professionals, and everyone has to go at their own pace. (Some people might decide it's not for them at all.)
You could direct your colleague to our Advocate for change: getting started page, which provides a brief guide to how advocacy fits in with the role of a child health professional, and suggests first steps and sources of support. Your colleague might want to start by advocating on an individual patient level (such as writing a letter to support a patient to move into better accommodation). This could help them to build confidence and find their voice.
The positive feedback of feeling that they are acting on a problem that concerns them and their patients might motivate your colleagues to continue expanding their sphere of influence.
Understand the RCPCH position statement and how you can use it
A position statement is a formal document that articulates an organisation's stance on a particular issue or topic, along with supporting evidence and recommendations for action. These statements guide organisational decision-making, ensure consistency of messaging and support advocacy activities.
Our position statement on air pollution is the cornerstone of our policy-influencing activity. In September 2024, we wrote to several key government officials to address the urgent need for action on air pollution. Our letters emphasised the severe impact of both indoor and outdoor air pollution on children's health, highlighting recommendations from our position statement tailored to each Minister's area of responsibility.
You can also use RCPCH position statements to support your advocacy work. For example, one of our policy calls is for the NHS to lead by example in adopting the Clean Air Hospital Framework. You might want to engage with your workplace around this, using the RCPCH position statement to reinforce your argument. We've created a quick read of the position statement on air pollution with this in mind - it's a 2-page version that's easy for you to print off and hand to a key decision-maker in your organisation. If you decide to use it, please let us know how it went at cleanair@rcpch.ac.uk.
Develop a relationship with your local councillor / MP
Through developing constructive long-term relationships with elected officials, child health professionals can influence the political agenda on air pollution and drive policy change.
RCPCH members can watch the recording of our free online webinar hosted jointly with Hope for the Future, a charity specialised in supporting people to have effective conversations with their politicians on climate and nature. This webinar will help you to make the most out of a child health professional background in highlighting air pollution in conversations with decision-makers.
Not sure who your elected representative is, or how to contact them? Write to Them is a good starting point - just enter your postcode to find a list of your local councillors and MP.
Engage the local media
Media engagement is a key skill for advocacy work that doesn’t form part of traditional medical curricula. This short media guide is designed to introduce you to basic principles for gaining local media attention for the issues you’re focused on. View here or download from the bottom of this page.
Engage your ICB or NHS Trust on air pollution
The Cheshire and Merseyside Integrated Care Board (ICB) developed an air quality framework in partnership with NHS Trusts and other partners in the region. It includes policy context, the impact on health and healthcare, sources of air pollution, air pollution measurement, existing frameworks, consultation, ICB priorities and recommendations.
This infographic summarises the key recommendations, which can be adapted by NHS Trusts in other regions.
Here's what you as a paediatrician can do:
1. Contact your NHS Trust’s sustainability manager
All NHS Trusts are required to have published a Green Plan and will usually have a sustainability manager (and sometimes a wider team). It is mandated in the Service Conditions of the NHS Standard Contract 2024/25 that NHS Trusts (and other NHS providers) take action on air pollution.
Your NHS Trust may already have great links into the ICB, but will really value the perspective of a paediatrician with all the possibilities that entails, including:
- Evidence contribution: You can provide data and research on the impact of air pollution on child health
- Pilot projects: There may be opportunities to develop pilot projects within your service
- Trusted voice: As an NHS clinician, your voice carries weight in advocating for cleaner air policies
2. Contact the ICB’s sustainability team
If you are unable to go via your NHS Trust’s sustainability manager or team, contact your ICB. As with NHS Trusts, all ICBs are required to have published Green Plans, and there is usually a sustainability lead or team responsible for implementing this work.
- Engage with the sustainability lead: They will be working on air quality and other green agenda initiatives across the ICB
- Highlight your role: Emphasise how your expertise in paediatrics can contribute to shaping air pollution policies and health strategies
- Collaborate on initiatives: Work with the team to integrate air quality considerations into clinical practice and patient education
By taking these steps, paediatricians and other healthcare professionals can actively engage with their ICB to address air pollution. Your input can help shape local policies, create effective interventions and improve health outcomes for children and communities.
With thanks to Lucy Vanes (Public Health Registrar, Manchester City Council) for her input. For further information, you can contact her at: Lucy.Vanes@manchester.gov.uk.
- 1Chief Medical Officer’s Annual Report 2022: Air Pollution